SubmissionId 60779

Accepted Type
Oral

Code
OE2-3-2

Was this work accepted for CCME 2020?
no

Category
General Call (Workshop, Oral Presentation, Poster Presentation)

Type
Oral

Sub Type
Education Research

Will the presenter be a:
Graduate Student

Affiliation

Considered for Poster
no

Title
Lost in Translation: Adaptations to implementation of Competence By Design

Length of Presentation

Background/Purpose
Given the complexity of the transition to competency-based medical education (CBME) and the diversity of systems, programs and learning contexts, the literature has acknowledged that a one-size-fits-all approach to implementation is unattainable. Customization and adaptation of curricula are crucial to ensure that the aims of CBME can be realized. Examining these adaptations and their effects is a priority for implementation research.

Methods
This constructivist grounded theory study explores the implementation of a CBME curriculum organized around entrustable professional activities (EPAs). To examine how implementation was unfolding in daily practice, we conducted individual semi-structured interviews with 17 faculty members and 11 residents from surgical and perioperative programs. Data collection and analysis were iterative.

Results
While participants embraced the objectives of the new CBME curriculum, they overwhelmingly reported that EPAs, as designed, did not fit within the context of their programs. In our data, we identified a series of adaptive strategies (e.g., delayed completion, minimal feedback etc.,) employed by faculty and residents. These adaptations effectively allowed faculty and residents to 'workaround' EPAs. In effect, the practices of implementation we were inquiring about were not recognizable as CBME. However, our data contained rich evidence of pre-existing teaching practices that are not explicitly part of the CBME implementation plan, but that deliver CBME-informed expectations.

Conclusion
Our results illustrate that both adaptations of CBME curriculum and pre-existing pedagogical practices may dilute or foster the principles of CBME.

Keyword 1
CBME

Keyword 2
Implementation

Keyword 3
EPAs

Level of Training
Post Graduate

Abstract Themes
Teaching and learning

Curriculum
Competency-Based Education

Teaching and Learning
Competency-Based Education

Additional Theme (First choice)
Postgraduate

Additional Theme (Second Choice)
Faculty Development

Additional Theme (Third Choice)
Assessment

Authors
Presenter
    Rachael Pack

Term 1
Yes

Term 2
Yes

Term 3
Yes

Term 4
Yes

Term 5
Yes
x

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